I have subdermallly implanted pellets of bioidentical estrogen and testosterone. I also take a small dosage of an iodine supplement. I have been prescribed bioidentical progesterone, 300 mg per night in capsule form, which I have been on for about a week. I had started bleeding, so three nights ago, I took only 150 mg. Two nights ago, I went back up to 300 mg. Two nights ago, my uterus cramped into a hard ball starting in the evening to a degree that it inteferred with going and staying asleep. My uterus continued to cramp progressively harder all day the next day. My job as a counselor is sedentary and cramping increased when I got up to escort clients to and from my office. I contacted my HRT replacement office who contacted the doctor who got back to me via email (which I can't access until late in the evening after work after their office closes) stating that this was an unusual side effect and I should get an ultrasound ordered by my gyno. NO advise about the progesterone and they aren't in the office on Fridays. Last night (Thursday) my uterus was cramped into such a hard and painful ball that it felt like a never ending hard labor cramp. The following things did NOT alleviate pain: Tylenol, ibuprphin, naproxen, wine, heating pad, muscle relaxer (I have on hand for rare bouts of sciatica). Upon going to bed, I decided to take NO progesterone that night. I couldn't possibly sleep because of the pain of my uterine cramp, so my husband suggested I take a pain killer that was left over from a surgery I had last summer. I took it at 10:30 PM. Cramping subsided about an hour later until 1:10 AM. I know it was bad of me, but I had to have relief and I took another pain pill at 1:20 AM. After it took hold, I slept until 8:30 AM. The cramping has started again. The office is closed today and all weekend. What should I do? Keep in mind I have the subdermal estrogen and testosterone pellets. Should I take NO progesterone, 150 mg, 300 mg, or the old 20 mgs that I have? Someone suggested to me that my particular system might respond better to bioidentical progesterone cream. IMMEDIATE CONCERN: What is your advise for the next three days concerning whether or not or how many mg of progesterone to take? fOR THE FUTURE: What is your opinion about cream vs. orally administered capsules? Unfortunately, it feels like I'm going to have to take a pain pill today in order to go to work, and I am a person who can tolerate a lot of pain and never takes the risk of getting hooked on anything by staying on it for long.